Wait times for many common surgeries and procedures were too long before the pandemic, and COVID-19 made them longer. Physicians are seeing patients sicker than they ought to be because of serious conditions that went undetected or untreated during the pandemic. Many people are frustrated, in pain, and unable to work and their condition may be deteriorating.
In response to these issues, the OMA released a comprehensive policy proposal, Integrated Ambulatory Centres: A Three-Stage Approach to Addressing Ontario’s Critical Surgical and Procedural Wait Times, in February 2022, outlining recommendations to reduce wait times through a new model of surgical and procedural delivery called Integrated Ambulatory Centres. Following the release of the proposal, the OMA continuously advocated to the provincial government about their potential benefits. The Ontario government announced in February 2023 plans, aligned in many ways with the OMA’s recommendations, to expand existing and create new community surgical and diagnostic clinics to move certain low-acuity procedures out of hospitals, starting with cataracts, diagnostic imaging and endoscopies, and later hip and knee replacements.
Your Health Act
In February 2023, the Ontario government introduced the Your Health Act, which outlines the next steps in its plan to reduce wait times for surgeries and diagnostic imaging. The bill includes measures for integrating community surgical and diagnostic centres into the health system, enhancing quality standards and oversight while protecting the stability of doctors, nurses and health-care workers in hospitals and other settings. Consistent with the Canada Health Act, the bill clarifies that people will only be able to access insured services at community surgical centres with their OHIP card.
The OMA had been advocating to the government on these issues for the past year via its white paper which was developed following extensive consultation with members and a jurisdictional scan.
The proposed legislation closely aligns with many of the key principles within the OMA’s white paper, including the need for system integration, improved quality oversight and careful consideration of human resources challenges.
The OMA will be monitoring these clinics to ensure they adhere to our four guiding principles:
- They must be connected to hospitals and broader Ontario Health regions. Integration is essential to ensure a smooth patient experience, protect patient safety and procedure quality, and support health-care human resource planning
- A health human resources strategy is needed to ensure these centres do not take resources away from hospitals or exacerbate existing HHR challenges including burnout
- We need to ensure that quality of care and patient safety levels are as high as in hospital settings
- These centres must offer publicly funded health-care services and operate within the Canada Health Act. They cannot lead to a two-tier system or queue-jumping
The OMA participated in public consultations and provided a formal submission to the government with these key policy recommendations.
Prescription for Ontario
One of the top priorities identified in the OMA’s Prescription for Ontario: Doctors’ 5-Point Plan for Better Health Care is to reduce wait times and the backlog of services. Relevant recommendations include:
- Providing adequate funding to address the backlog in hospitals and community clinics
- Evolving the model of surgical care delivery to include a greater portion of services delivered in community-based specialty settings outside of hospitals.
- Ensuring there are enough nurses and technologists to expand MRI and CT machine hours, and for ultrasound and mammography
The OMA submitted its 2023 pre-budget recommendations on Feb. 14, 2023, and urged the Ontario government to include our solutions in its 2023-24 budget, which featured three solutions that can be implemented immediately to make a difference to patients, including: increasing system capacity and improving patient access to care by creating a centralized wait list and referral system for surgeries so that patients with the greatest need go to the front.
Implementation of a centralized intake, referral and triage management system was a key recommendation in the OMA’s white paper.
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Dr. Rose Zacharias on The Agenda
Live Now: Ontario's Health Care Solution https://t.co/is1jq787Nj— The Agenda | TVO Today (@TheAgenda) January 21, 2023
The OMA president appears on this January 2023 episode of The Agenda to discuss the government of Ontario’s announcement that it will allow more private delivery of health care to try to help tackle the lengthy wait lists for surgeries and procedures created by the COVID-19 pandemic.
Related articles from the Ontario Medical Review
The OMR has featured stories on advocacy and its results related to wait times and doctor shortages, the backlog and IACs.